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Universal Depression Screen of Ambulatory Heart Transplant Recipients With Referral for Mental Health Intervention: A
Laura L Peters1, Amrut V Ambardekar, Laura D Rosenthal
1Section of Advanced Heart Failure and Transplantation, Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (Drs Peters, Ambardekar, and McIlvennan); College of Nursing, University of Colorado, Aurora (Dr Rosenthal); and Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora (Dr McIlvennan).
Background:
Patients with a heart transplant and depression have higher rates of graft failure and noncompliance.
Local Problem:
The heart transplant clinic had no standardized approach to assess for depression.
Methods:
The heart transplant clinic implemented routine use of the Patient Health Questionnaire (PHQ).
Interventions:
Team members were educated via an online module about depression. A process for depression screening and follow-up was developed and implemented.
Results:
From July 2018 to February 2019, there were 834 visits; PHQ2 screens were completed during 779 (93%) of those visits with 40 (5%) positive screens. All 40 patients had PHQ9 assessment, with 33 patients (4%) exhibiting moderate or severe depressive symptoms. All 33 patients were provided with mental health resources and received follow-up. Median time to administer PHQ2 was 2 minutes (range 1-3 minutes).
Conclusions:
Implementation of universal depression screening in a heart transplant clinic is feasible, identifies patients with depression, and does not add significant clinical burden.
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